Papers by catherine kleitz
Revue Neurologique, Jun 1, 2020
While cognition and depression have often been studied in patients with epilepsy, only a few stud... more While cognition and depression have often been studied in patients with epilepsy, only a few studies have so far attempted to link these two domains, and more specifically to investigate the specific impact of depression on cognition in epilepsy. In this review, we performed an extensive search of the literature database to provide a better understanding of this subject. Using several inclusion criteria (adult population, quantitative depression/neuropsychological assessment, statistical analyses of the impact of depression on cognitive scores, patients with epilepsy (PWE) and no other neurological disease, and studies including at least 20 patients), we identified 20 articles (out of 712 search results) that investigated both depression and cognition in PWE. Their results were summarized using a narrative and descriptive approach. This review highlights a variable impact of depression on cognition in PWE, depending on the laterality of the seizure onset zone, the type of epilepsy and the surgical context. We emphasize the need for a systematic depression assessment in these patients, especially since depressed PWE will benefit from prompt and appropriate care to help them avoid cognitive decline, particularly in a surgical context.
Revue Neurologique, 2007
Trouble du langage dans la dégénérescence corticobasale : discussion d'une observation
BMJ Open
IntroductionSoccer is the most popular sport in the world. This contact sport carries the risk of... more IntroductionSoccer is the most popular sport in the world. This contact sport carries the risk of exposure to repeated head impacts in the form of subconcussions, defined as minimal brain injuries following head impact, with no symptom of concussion. While it has been suggested that exposure to repetitive subconcussive events can result in long-term neurophysiological modifications, and the later development of chronic traumatic encephalopathy, the consequences of these repeated impacts remain controversial and largely unexplored in the context of soccer players.Methods and analysisThis is a prospective, single-centre, exposure/non-exposure, transverse study assessing the MRI and neuropsychological abnormalities in professional retired soccer players exposed to subconcussive impacts, compared with high-level athletes not exposed to head impacts. The primary outcome corresponds to the results of MRI by advanced MRI techniques (diffusion tensor, cerebral perfusion, functional MRI, cer...
<p>T = P<0.001, uncorrected, extent threshold of 30 voxels.</p><p>BA = Brodm... more <p>T = P<0.001, uncorrected, extent threshold of 30 voxels.</p><p>BA = Brodmann’s area, DSST = Digit Symbol Substitution Test, imm. = immediate, L = left, R = right, NA = not applicable, PASAT = Paced Auditory Serial Addition Test, SRT = Selective Reminding Test.</p
*<p>Blind patients were not tested for these tests.</p><p>NMO = Neuromyelitis O... more *<p>Blind patients were not tested for these tests.</p><p>NMO = Neuromyelitis Optica; BCcogSEP = French translation of the Brief Repeatable Battery.</p
<p>Note that the NMO group overall showed a decreased WM volume in the frontal and parietal... more <p>Note that the NMO group overall showed a decreased WM volume in the frontal and parietal lobes (including the superior longitudinal fascicle), corpus callosum, cerebellum, brainstem and optic chiasm compared to healthy control subjects. (<i>P</i><0.05, false discovery rate, cluster size threshold >30 voxels).</p
<p>For each cluster, the extension in which local maxima are located, along with the coordi... more <p>For each cluster, the extension in which local maxima are located, along with the coordinates in the MNI space and the T level of the most significant voxel are reported.</p><p>T = <i>P</i><0.05, corrected using false discovery rate (FDR). BA = Brodmann’s area, L = left, R = right, NA = not applicable.</p
<p>Note the correlations with corpus callosum and the pons. Statistical maps were threshold... more <p>Note the correlations with corpus callosum and the pons. Statistical maps were thresholded without correction, with <i>P</i> value <0.001 and with a minimum cluster size of 30 voxels.</p
<p>Note that the NMO patients with cognitive impairment have a large decreased WM volume in... more <p>Note that the NMO patients with cognitive impairment have a large decreased WM volume including brainstem, cerebellum, corticospinal tracts but also the important fascicles of the brain such as corpus callosum, superior longitudinal fascicle and inferior longitudinal fascicle. (<i>P</i><0.05, false discovery rate, cluster size threshold >30 voxels). Sagittal view of the brain using xjview.</p
Epileptic Disorders, 2002
Les epilepsies focales liees a l'âge et notamment l'epilepsie a paroxysmes rolandiques (E... more Les epilepsies focales liees a l'âge et notamment l'epilepsie a paroxysmes rolandiques (EPR) ou a pointes centro-temporales (EPCT) sont considerees comme etant d'excellent pronostic avec une disparition spontanee des crises et des anomalies electroencephalographiques (EEG) a l'adolescence. L'individualisation de ce syndrome par Beaussart et Nayrac en 1959 a ete une avancee considerable en epileptologie infantile : il existait des epilepsies focales non lesionnelles, « benignes », d'evolution spontanement favorable. Depuis, ont ete conduites plusieurs etudes portant sur le developpement cognitif et les apprentissages de ces enfants au cours de la maladie, apportant des resultats heterogenes. Toutes les etudes s'accordent a dire cependant que les enfants atteints d'epilepsie a paroxysmes rolandiques gardent une efficience intellectuelle normale au cours de leur evolution et un excellent pronostic a long terme. Neanmoins, chez certains d'entre eux, p...
Epilepsies, 2001
De nombreuses etudes ont affirme le caractere benin de l'epilepsie partielle idiopathique ave... more De nombreuses etudes ont affirme le caractere benin de l'epilepsie partielle idiopathique avec pointes centro-temporales (EPCT). Neanmoins, des donnees recentes ont montre que certains patients peuvent developper des complications neuro-psychologiques severes, mais reversibles, au cours de l'evolution de ce syndrome. Nous avons tente de decouvrir des marqueurs predictifs de ces risques au travers d'une etude prospective d'enfants satisfaisant initialement aux criteres diagnostiques classiques d'EPCT. Trente-cinq cas ont ete recrutes des leur premiere crise, et 5 nous ont ete adresses en raison d'une evolution atypique. Des evaluations socio-familiales, neuro-psychologiques et neurologiques ainsi que des EEG de veille et de sommeil ont ete repetes regulierement jusqu'a la guerison complete. Chez 25 des 35 patients non selectionnes (72 %), le comportement et les capacites cognitives sont restes intacts. Chez 7 (20 %), des difficultes comportementales, scola...
Epilepsy & Behavior, 2019
Introduction: Neuropsychological assessment is an integral component of the surgical procedure in... more Introduction: Neuropsychological assessment is an integral component of the surgical procedure in patients with epilepsy. As no French consensus for neuropsychological assessment was available, the main goal of this work was to define French neuropsychological procedure consensus in regard to literature review. Method: A panel of expert in neuropsychology was created within the framework of the French League Against Epilepsy. A systematic search of publications from 1950 to 2017 listed in PubMed database was conducted leading to a classification of articles according to their level of scientific evidence. French neuropsychological procedure consensus was then carried out with an expert panel of expert. Results: Low scientific evidence of neuropsychological data was reported. A panel of expert proposed a comprehensive neuropsychological assessment procedure including the exploration of intellectual efficiency, long-term memory, short-term and working memory, attention, executive functions, processing speed and motor skills, language, visual processing, praxis, psychobehavioral, and social cognition. Discussion: A common procedure for assessing cognitive and psychobehavioral function is now available in patients with epilepsy undergoing surgical evaluation have been established, they may help to improve the quality of care and the patient experience. This work highlights the need of furthers investigations and the necessity to develop specific tools with normative data.
Epilepsia, 2017
Background: Aiming at the harmonization and establishment of common standards in the neuropsychol... more Background: Aiming at the harmonization and establishment of common standards in the neuropsychological assessment of surgical patients with epilepsy, the current practice in European epilepsy centers was evaluated. Method: Twenty-six epilepsy centers joining "E-PILEPSY", an EU funded pilot network of European reference centers for drug resistant epilepsy and epilepsy surgery, were asked to report the status of neuropsychological assessment in adults and children via two different surveys. Results: It was agreed that neuropsychology is an essential part of presurgical work-up. Large agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuo-spatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use, a core group of tests reflecting minimal agreement could be discerned. Variability exists with regard to indications, protocols and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants of the survey reported a need for improvements concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms and test conormalization. Conclusion: Based on this survey, a consensus on the indications and principles of neuropsychological testing was achieved. Despite the variety of tests in use, the survey indicated there may be a core set of tests which appear to result from experience as well as published evidence. By combining with the results of an ongoing systematic literature review, we aim for a battery which can be recommended for the use across epilepsy surgical centers in Europe.
Neurology, Feb 12, 2013
OBJECTIVE: To describe patients with dementia and a positive intrathecal anti-Borrelia antibody i... more OBJECTIVE: To describe patients with dementia and a positive intrathecal anti-Borrelia antibody index (AI). BACKGROUND: Lyme dementia has not been previously described. DESIGN/METHODS: Patients: Among 8437 different patients seen for cognitive impairment, we prospectively identified and studied 18 patients with dementia and a positive AI and compared them to controls. Main Outcome Measures: A battery of neuropsychological tests was assessed (Mini-Mental State Examination, Mattis Dementia Rating Scale, Frontal assessment Battery, memory (FCSRT), the Rey-Osterrieth Complex Figure Test and a verbal task. All patients also underwent brain MRI, FDG-PET and CSF analysis. An etiological diagnosis of the dementia for each patient was made at the end of the follow-up of 5.2 ±3.0 years. RESULTS: We found two groups of patients with dementia, the first (n=6) with certain neuroborreliosis and stability or mild improvement of dementia after treatment by antibiotics and the second (n=12) with progressive worsening of dementia, despite the antibiotics. In the second group, the final diagnoses were Alzheimer9s disease (AD) (n=4), AD and Lewy body disease (LBD) (n=3), LBD (n=1), frontotemporal dementia (n=3), and hippocampal sclerosis (n=1). Cognitive performances were significantly lower in the two groups than in controls. We did not observe differences in cognitive test and biological results between the two patient groups. Brain MRI showed more focal atrophy in the second than in the first group. CONCLUSIONS: Lyme dementia is of rare occurrence, with a good outcome. The majority of patients with dementia and positive AI have a neurodegenerative disease. Disclosure: Dr. Blanc has received personal compensation for activities with BIOGEN IDEC, NOVARTIS, JANSSENS-CILAG and EISAI, BAYER SCHERING PHARMA, TEVA, MERCK, SANOFI. Dr. Philippi has nothing to disclose. Dr. Cretin has nothing to disclose. Dr. Kleitz has nothing to disclose. Dr. Berly has nothing to disclose. Dr. Kremer received personal compensation for activities with Biogen, Bayer, Sanofi Aventis, and Bracco. Dr. Kremer has received personal compensation in an editorial capacity for "Journal de Neuroradiologie" and "Journal de Radiologie". Dr. Kremer has received research support from Biogen, Bayer, Sanofi Aventis, and Bracco. Dr. Namer has nothing to disclose. Dr. Jaulhac has nothing to disclose. Dr. De Seze has received personal compensation for activities with Allergan, Inc., Almirall, Bayer Schering, Biogen Idec, Genzyme Corporation, LFB, Merck Serono, Sanofi-Aventis Pharmaceuticals, Inc., and Teva Neuroscience.
Epileptic Disorders, Jan 31, 2002
Les epilepsies focales liees a l'âge et notamment l'epilepsie a paroxysmes rolandiques (E... more Les epilepsies focales liees a l'âge et notamment l'epilepsie a paroxysmes rolandiques (EPR) ou a pointes centro-temporales (EPCT) sont considerees comme etant d'excellent pronostic avec une disparition spontanee des crises et des anomalies electroencephalographiques (EEG) a l'adolescence. L'individualisation de ce syndrome par Beaussart et Nayrac en 1959 a ete une avancee considerable en epileptologie infantile : il existait des epilepsies focales non lesionnelles, « benignes », d'evolution spontanement favorable. Depuis, ont ete conduites plusieurs etudes portant sur le developpement cognitif et les apprentissages de ces enfants au cours de la maladie, apportant des resultats heterogenes. Toutes les etudes s'accordent a dire cependant que les enfants atteints d'epilepsie a paroxysmes rolandiques gardent une efficience intellectuelle normale au cours de leur evolution et un excellent pronostic a long terme. Neanmoins, chez certains d'entre eux, peuvent apparaitre un deficit oromoteur transitoire, des troubles neuropsychologiques specifiques, ou des troubles attentionnels retentissant sur les apprentissages scolaires, au cours de la phase active de la maladie. L'analyse des correlations neuropsychologiques et neurophysiologiques met en evidence un effet significatif de la lateralite du foyer pour de rares epreuves specifiques. La presence prolongee d'un foyer lent intercritique et de pointe-ondes amples et tres activees au sommeil sont associees de facon significative a une baisse des performances cognitives et a des troubles attentionnels. Ces anomalies sont observees essentiellement au cours des formes dites severes ou atypiques. Les premieres etudes longitudinales confirment le caractere transitoire de ces deficits. Ainsi l'existence d'un foyer epileptique actif, en l'absence de toute lesion, ou meme de traitement, interfererait avec la maturation de fonctions cognitives en cours de developpement.
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Papers by catherine kleitz